1. Technical Field
The present invention relates to pathologic evaluation of tissue specimens and in particular to the identification of the anatomic orientation of tissue specimens submitted for pathologic evaluation.
2. Related Art
Tissue specimens removed during surgery must be anatomically oriented with respect to structures from which they have been excised and the body of the patient in order for pathologists to make a proper pathological diagnoses.
By medical consensus and convention, anatomic orientation is made with respect to a standard anatomic position in which a human being stands erect with his or her arms supinated. With respect to the standard anatomic position, the head is superior or cephalad and the feet are inferior or caudad. The chest is anterior or ventral and the back is posterior or dorsal. The arms are lateral and the heart is medial.
In keeping with this convention, if for example, a tissue specimen is removed from the lobe of a patient's lung in the approximate form of a cube, the faces of the cube may be identified as: superior or cephalad; inferior or caudad; anterior or ventral; posterior or dorsal; lateral; and, medial.
Should the exemplary cube of tissue be found by a pathologist to contain a tumor, the orientation of the tumor with respect to the lung from which it has been removed will be critical to the surgical treatment of the patient. Accordingly, surgeons removing tissue specimens for pathological and histopathological diagnoses, and excising tissues until they are assured by a pathologist of tumor-free resection margins, must label the tissue specimens in a manner that unambiguously orients them with respect to the anatomical structure and person from which they are excised.
Such labeling is typically accomplished by passing a suture through as many faces or aspects of a tissue specimen as are required to orient it unambiguously. For example, a surgeon may place a short black silk suture along a medial aspect of a tissue specimen, and a long black silk suture along an inferior aspect of a tissue specimen. Alternatively, a surgeon may identify a lateral aspect of a tissue specimen by passing a double loop of suture through its lateral margin, and may identify an inferior margin by passing a single loop of suture through its inferior margin. Margins, aspects, or faces of a tissue specimen may also be distinguished and identified with respect to anatomical orientation by passing sutures of different colors.
In each case, the suture length, suture configuration (i.e., single loop, double loop, etc.) or suture color that establishes an anatomic orientation for a tissue specimen is dictated aloud to another health care provider in the operating room, such as, for example, a circulating nurse. The circulating nurse typically prepares a written legend that correlates each suture with the dictated anatomic orientation. The written legend accompanies tissue specimens to the pathology laboratory, where its anatomic orientating information is used in the pathologic evaluation of the tissue specimens. For example, after checking the orienting sutures against the legend, pathology laboratory personnel will know how each tissue specimen was originally seated prior to its removal. This information is essential to accurate pathologic descriptions of the specimen and its surrounding tissues.
Establishing the anatomic orientation of a tissue specimen by the use of sutures of different lengths, colors or configuration is confusing and prone to errors. For example, sutures may unravel and the foregoing legend may be transcribed improperly or may be poorly legible.
Accordingly, there exists a need for the efficient, convenient and unambiguous anatomic orientation of tissue specimens for purposes of pathological diagnoses, and pathologically-guided surgical resections.